In all fairness, this is an important part of the neurologic examination.

We saw a patient in clinic yesterday with "loss of peripheral vision" in his right temporal field secondary to suspected VZV reactivation. Fortunately, upon retraction of his swollen upper eyelid, his visual fields were full to confrontation.

OK I'm a layperson, but couldn't droopy eyelids be caused by something like Myasthenia Gravis or some other type of disease, or toxicity? Could botulism poisoning cause it, or is that double vision only? What if it had been something really serious?

anon: oh yes, visual loss can be a very serious matter, so we do work it up properly.

Of course, -properly- implies some sense to the entire matter. Sense, such as making sure drooping eyelids, eyepatches, sleep, eyes-swollen-shut and so forth do not interfere with the assessment of acuity and visual field. Possibly before an MRI is ordered for *gasp* blindness.

My brother has benign idiopathic blepharospasm. He was blind until after the myomectomies, the neurectomies and the botox injections. Fortunately, after all that, he can control it w/ cyclobenzaprine. Sometimes it isn't all that easy to simply open one's eyes.

I once treated a young man who complained that he woke up with double vision. Astute diagnostician that I am, I noticed that his glasses were canted on his nose at about 30 degrees. I had him remove his glasses and his diplopia resolved.

Yes my Aunt's surgery was covered by medicare. Her surgeon did a good job. She didn't look "done", just well rested (she was in her 80's) and more importantly now she could see. I expect my older brother will need the same surgery someday, he has that side of the family's facial structure and at 50 his eyelids are already droopy.

Welcome to my whining!

This blog is entirely for entertainment purposes. All posts about patients may be fictional, or be my experience, or were submitted by a reader, or any combination of the above. Factual statements may or may not be accurate.

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